KATHLEEN L CULLOP (NPI# 1063691137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063691137 |
| Entity Type | Individual |
| Full Name | KATHLEEN L CULLOP |
| Credential | LCPC |
| Practice Address |
1207 S Mattis Ave Suite 4 Champaign IL 61821-4861 |
| Practice Telephone | 2173988067 |
| Practice Fax Number | 2173988096 |
| Mailing Telephone | 2173988067 |
| Mailing Fax Number | 2173988096 |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2007-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 103-2051 | 01 |
| Street Address |
1207 S MATTIS AVE SUITE 4 |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821-4861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720038128 | Kevin Stachnik | Chiropractor | 1207 S Mattis Ave, Ste 2, Champaign, IL 61821-4861 | 2006-05-10 |
| 1215117387 | Marcia M. Clark | Counselor | 1207 S Mattis Ave, Suite 4, Champaign, IL 61821-4861 | 2007-11-06 |
| 1679698526 | Accent Counseling LLC | Counselor | 1207 S Mattis Ave, Suite 4, Champaign, IL 61821-4861 | 2007-03-20 |
| 1023061280 | Edward Soojin Chun | Chiropractor | 1207 S Mattis Ave, Ste2, Champaign, IL 61821-4861 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| Find all providers in zip 61821 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712890 | Sophia Dixon | Counselor | 313 N Mattis Ave Ste 116, Champaign, IL 61821-7900 | 2020-08-28 |
| 1720607872 | Joyce Bechtel | Counselor | 100 N Chestnut St Ste 225, Champaign, IL 61820-3329 | 2020-04-09 |
| 1356975643 | Jamie Sue Stevens | Counselor | 201 W Springfield Ave Ste 208, Champaign, IL 61820-4875 | 2020-02-26 |
| 1639716624 | Melanie L. Bailey | Counselor | 701 Devonshire Dr Ste B16-b18, Champaign, IL 61820-7337 | 2019-12-09 |
| 1659932663 | George W. Cook Professional Corporation | Counselor | 1002 Mayfair Rd, Champaign, IL 61821-4435 | 2019-06-21 |
| 1891352142 | Staci Poe Counseling Services | Counselor | 53 E Bradley Ave, Champaign, IL 61820-2741 | 2019-05-22 |
| 1861968240 | Imani Taliah Harrison | Counselor | 701 Devonshire Dr Ste C53, Champaign, IL 61820-7361 | 2018-10-23 |
| 1790265825 | Anna Farris | Counselor | 201 W Springfield Ave Ste 1005, Champaign, IL 61820-4968 | 2018-08-17 |
| 1437635752 | Sheldon Gerrard Aaron | Counselor | 201 W Springfield Ave Ste 1201, Champaign, IL 61820-6385 | 2018-07-19 |
| 1114418456 | Rebecca Pauline Harrison | Counselor | 201 W Springfield Ave Ste 1006, Champaign, IL 61820-6379 | 2018-05-22 |
| Find all providers in CHAMPAIGN | ||||
Please comment or provide details below to improve the information on KATHLEEN L CULLOP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.